From the Guidelines
The target bedtime (qhs) glucose range for gestational diabetes is less than 5.3 mmol/L, as recommended by the most recent guidelines. This range helps maintain optimal blood glucose levels overnight to prevent fasting hyperglycemia, which can affect both maternal and fetal outcomes. Women with gestational diabetes should aim to check their blood glucose before bedtime and ensure it falls within this range. If bedtime glucose levels are consistently outside this target range, adjustments to evening meals, snacks, or medication may be necessary. A small protein-containing snack before bed (such as a small piece of cheese or a few nuts) can help prevent overnight hypoglycemia while maintaining target levels. This specific target range is important because elevated overnight glucose levels can lead to fetal hyperinsulinemia and macrosomia, while levels that are too low could trigger maternal hypoglycemia during sleep. Regular monitoring and maintaining this target range helps ensure better pregnancy outcomes and reduces complications associated with gestational diabetes, as supported by the guidelines from the American Diabetes Association 1.
Some key points to consider:
- Fasting glucose targets are less than 5.3 mmol/L, and either one-hour postprandial glucose is less than 7.8 mmol/L or two-hour postprandial glucose is less than 6.7 mmol/L, as recommended by the guidelines 1.
- Achieving these targets can help prevent complications associated with gestational diabetes, such as fetal hyperinsulinemia and macrosomia, and reduce the risk of maternal hypoglycemia during sleep.
- Regular monitoring of blood glucose levels, including before bedtime, is essential to maintain optimal glucose control and prevent complications.
- Adjustments to evening meals, snacks, or medication may be necessary to achieve the target glucose range, and a small protein-containing snack before bed can help prevent overnight hypoglycemia.
From the Research
Target QHS Glucose Range for Gestational Diabetes
The target QHS (quasi-hemostatic state) glucose range for gestational diabetes is not explicitly stated in the provided studies. However, the studies discuss the importance of glucose monitoring and control in gestational diabetes.
Glucose Monitoring and Control
- Glucose monitoring during pregnancy is essential for ensuring appropriate glycaemic control and reducing associated risks 2.
- The current methods of glucose monitoring include measuring glycosylated haemoglobin (HbA1c), self-monitoring of capillary blood glucose (SMBG), and continuous glucose monitoring (CGM) 2.
- Observational studies and randomized controlled trials (RCTs) have assessed the appropriate glycaemic targets for HbA1c, SMBG, and CGM in relation to pregnancy outcomes 2.
Gestational Diabetes Management
- Metformin is an effective alternative to insulin in the treatment of gestational diabetes mellitus (GDM) 3, 4, 5.
- Metformin was beneficial in reducing neonatal birth weight and neonates in the metformin-treated group suffered fewer rates of neonatal hypoglycemia and NICU admission 3.
- The majority of studies used to define the glucose targets associated with the best pregnancy outcomes were in women with type 1 diabetes, with limited studies on women with type 2 diabetes and gestational diabetes 2.
QHS Glucose Range
There are no research papers provided that directly answer the question of the target QHS glucose range for gestational diabetes in mmol/L.